Adoption of Food Code Provisions Is Linked to Lower Rates of Foodborne Norovirus Outbreaks

States that adopted key provisions from the Food Code had lower rates of foodborne norovirus outbreaks. These provisions require restaurants, delis, caterers, and others to

clock icon Exclude sick staff for at least 24 hours after symptoms have gone away.

badge icon Have a certified food protection manager (manager who has passed a test to show knowledge of food safety).

hands wash icon Prohibit food workers from touching ready-to-eat food with bare hands (bare-hand contact). Ready-to-eat food can be served without washing, cooking, or other preparation.

Why This Study Is Important

Norovirus is the leading cause of foodborne disease outbreaks in the United States. The Food Code is designed to help prevent outbreaks of pathogens like norovirus, but state and local governments must decide if they will adopt any of the provisions. The study was done to find out which states adopted key provisions of the Food Code and whether states that adopted those provisions had lower rates of outbreaks.

What Is the Food Code?
book cover with FDA on it.

The Food Code is published by the Food and Drug Administration (FDA). It contains science-based guidance to improve food safety in restaurants, delis, caterers, and others. States, tribes, localities, and territories can use it as a model for their own food safety rules for these establishments.

What the Study Described

This study described state-level adoption of provisions in the Food Code related to preventing foodborne norovirus outbreaks. The authors examined Food Codes for all 50 states and the District of Columbia to determine which states had adopted these provisions.

They also used data from CDC’s National Outbreak Reporting System to find out how many foodborne norovirus outbreaks occurred from 2009 through 2014. The authors compared the rates of norovirus outbreaks in states that adopted key provisions of the Food Code with states that did not.

What the Study Found

States that adopted three specific provisions of the Food Code had lower rates of foodborne norovirus outbreaks per million person-years than states without these provisions.

States that adopted the Food Code provision to exclude sick staff had lower rates of foodborne norovirus outbreaks per million person-years (0.44) than states without the provision (0.73). States that adopted the Food Code provision to require a certified food protection manager had lower rates of foodborne norovirus outbreaks per million person-years (0.38) than states without the provision (0.75). States that adopted the Food Code provision to prohibit bare-hand contact had lower rates of foodborne norovirus outbreaks per million person-years (0.45) than states without the provision (0.74).